2024-25 Children & Youth Registration Form

Please use this form to register your child(ren) and youth for Religious Education (including childcare) for the 2024-25 year.

Child

Child's Name

Please type first and last name

Nickname

What the child prefers to be called, if different from above

Child's Pronouns

Date of Birth

School

Name of school this child attends

Grade (or homeschool equivalent) in 2024-25 Program child will attend

If you are not sure about the best fit for your child, please leave a note in the "Additional Information" field below

Photo Release

Yes No

I release my child's photo to be included on the Unitarian Universalist Church of Bloomington's website, facebook page, and/or newsletters. (Names of children are never included with photo.)

Please describe your child's allergies, medical conditions, or special needs.

What are your child's primary interests or hobbies?

Is there anything else you would like us to know about this child?

Who is authorized to pick up your child?

Please list ALL applicable adults and older siblings. Children in 3rd grade and older will be released on their own, unless otherwise specified.

Is there anything else you'd like us to know?

2024-25 Children & Youth Registration Form

Household Information